Definition

• A circumcision is the removal of most of the male foreskin
• Questions about caring for the normal circumcised penis in a baby boy

Health Information

Symptoms

• The incision starts off red and tender. The tenderness should be much less by day 3.
• The head of the penis is bright red. It stays that way for a few weeks.
• The shaft of the penis is skin colored, not red.
• The incision can bleed 1 or 2 drops if it is irritated.

Normal Circumcision Healing

• The scab at the incision line comes off in 7 to 10 days.
• If a Plastibell (plastic ring) was used, it should fall off by 14 days. 10 days is the average. While it can’t fall off too early, pulling it off can cause bleeding.
• Complications: Wound infections occur in less than 1 out of 200 circumcised boys.

American Academy of Pediatrics (AAP) Policy

• Based on new research, the AAP revised their position on male circumcision (2012).
• They now state that the health benefits outweigh the risks of the procedure.
• But, the benefits are not great enough to recommend routine circumcision for all newborns.
• Parents need to decide what is best for their child.

Care Advice

1. Overview:
   • The tip (head) of the penis can be red after the foreskin is removed. This is normal.
   • The rest of the penis should not be red.
   • Most circumcisions heal quickly.
   • Infections are rare.
   • Here is some care advice that should help.
2. Plastic Ring:
   • Gently wash the area with warm water twice a day.
   • Also, do this if it becomes dirty with poop.
3. Incision (No Plastic Ring is Present):
   • The dressing is gauze with petroleum jelly. Take this off 24 hours later. Sometimes, it will fall off on its own. If you need to remove it, use a warm wet washcloth.
   • Gently wash the area with warm water twice a day. Also, do this if it becomes dirty with poop.
4. Ointment for Pain:
   • Put a layer of ointment on the incision line. This should lessen any pain and crying.
   • To prevent pain, use petroleum jelly. Put it on the incision line and head of the penis. Do this after each cleansing for the first 4 days. Other option: You can also use an antibiotic ointment. No prescription is needed.
   • Reason: Helps keep it soft and stops the diaper from sticking during healing.
5. Crying - Don’t Give Pain Meds:
   • Circumcisions are usually not that painful.
   • Covering the wound with an ointment usually is all that is needed.
   • Do not give pain medicine (such as Tylenol) routinely.
   • If your baby is crying a lot, he may need to be seen. Call your doctor if you think your baby is in pain.
   • Your baby’s doctor will decide if pain meds are needed.
6. Bleeding - How to Stop:
   • The circumcision wound can normally bleed a few drops. Most often, this is caused by the diaper rubbing on the wound.
   • Will stop on its own or with a few minutes of direct pressure.
   • Can stop bleeding by keeping the area soft with an ointment.
7. Prevent Infections:
   • Fasten the diaper loosely to prevent friction against the penis.
   • Avoid tub baths until 2 days after the cord has fallen off.
   • For circs done later, avoid tub baths for 7 days.
8. What to Expect For A Plastic Ring:
   • The plastic ring will normally fall off between 7 and 14 days (average 10).
   • It often hangs by a small piece of tissue for a few days.
   • It will come off on its own.
   • Pulling it off can cause bleeding.
   • It can’t fall off too early.

Call Your Doctor If

• Starts to look infected
• Bleeding occurs
• Plastic ring moves onto shaft of the penis
• Plastic ring does not fall off by day 14
• You think your child needs to be seen
• Your child becomes worse

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

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